I’m in bipolar depression relapse, which is awful. I had a great 2 1/2 years of remission.

Over the course of the last 17 years I’ve had perpetual, off and on med burnout, which has a very geeky name, Antidepressant Therapy Tachyphylaxis, which means the antidepressants just stop working. I think a lot of people have this problem but there’s a black void where knowledge should be.

Articles on it, and other names for it, like “Prozac Poopout” are all over the internet. In the past we’ve resolved it over time by cycling to newer meds. Pristiq, then Viibryd and finally Brintellix, (now called Trintellix) and then Fetzima, which didn’t work.

Two different times we used Trintellix, which worked for a few years, and needed to be discontinued and then worked again when we ‘recycled it.’

I’m worried. I think I’ve burnt out all the drugs that act on Dopamine, Serotonin, Norepinephrine and need to go to a different class like a tricyclic or MAOI. The fact that I have Tardive Dyskinesia reduces our treatment options greatly.

I think it might eliminate an MAOI, because monoamines factor into TD…in some way.

I am writing my book and possibly have an autoimmune illness called Sjogren’s or ‘Sicca Syndrome.’ Can’t wear contacts, on these eyedrops, fatigue. I don’t have manic energy at all, which I had enjoyed. Always tired. One of the things about writing, especially a research driven book, is it’s a lot of work. I need to put in four hours a day to really make any progress. Am considering dropping my gym membership. Then I’ll go back to looking like THIS again. It takes about four months to take that extra 20 off.